HomeMy WebLinkAboutDrain Layers Permit 46 Hazel Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'.S PERMIT NO 1335
19
Pursuant to written application perms on is hereby anted to the Licensed Drain Layer named herein to perform—
the work i dic ted w at Z z !i l� on the
OU side, between
j � rd
at remises owned b a 0 + Q `
whose address is
and to X-Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL AS R ( )
a ��
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
'} Signed ��Gw�
Connection Charge Paid 37 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED 6 77 (Date)
y
Yi (Sig)
INSPEC OR
t
-
4�
�w
c
v �
!
N6., a'fe - �g ------ -
P4
sc)utN WIN:W5 V? ;'(�� !-UTW-N CONTROL
#..Q C ATI ON ,
_ Cs ono ico,2 i) '
�iNSTA
{� T /33S PIPE
(iV;fl 3i� , �'� i. (�RAWNDY---N 1